Cavernous Malformations

Cavernous malformations, also called cavernous angiomas and cavernomas, are abnormal clusters of dilated blood vessels. These masses are made up of little pockets, called caverns. They are filled with blood and lined with a special layer of cells, called the endothelium. These malformations can cause seizures, stroke symptoms, hemorrhages and headache.

Ranging in size from microscopic to inches in diameter, cavernous malformations can be located anywhere in the body including the liver, rectum, kidney, eyes, nerves, spinal cord and brain. Those that develop in the brain or spinal cord, called cerebral cavernous malformations (CCM), are the most serious.

About one in 200 people have a cavernous malformation, affecting men and women almost equally and occurring in people of all races, sexes and ages. In some cases, these malformations may run in families and are inherited. The abnormality either occurs spontaneously, typically with one lesion or frequently, producing many lesions.

Some people — roughly 15 percent — with cavernous malformations may not experience any symptoms at all, while others may suffer from a variety of effects. Symptoms typically depend on the location of the malformation and may include:

Seizures ranging in severity, duration and intensity

Neurological deficits, such as weakness in arms and legs as well as problems with vision, balance, memory and attention

Headaches ranging in severity, duration and intensity

Bleeding, called a hemorrhage, in the brain that may damage surrounding brain tissue

Cavernous malformations usually are not diagnosed until they start causing symptoms. When possible symptoms appear, your doctor may recommend a magnetic resonance imaging (MRI) scan, which remains the best way to diagnose cavernous malformations.

MRI scans may be repeated over the course of your treatment to detect any change in the size of the malformation, recent bleeding and the appearance of new lesions. MRI is a non-invasive procedure that uses powerful magnets and radio waves to construct pictures of the body.

Currently, the treatments available for cavernous malformations include observation and surgery.

Observation — If your cavernous malformation does not seem to be causing any problems, your doctor may recommend that the malformation simply be observed with yearly magnetic resonance imaging (MRI) scans to detect any changes.

However, it is impossible to predict what will happen with any cavernous malformation. Some will cause repeated hemorrhages with worsening symptoms such as headaches, seizures, difficulty speaking, vision problems or weakness in the arms or legs, while others remain inactive and do not cause symptoms for many years.

Surgery — Surgery is often recommended for the treatment of cavernous malformations. Because these malformations are so distinct from the surrounding brain tissue, they can at times be completely removed and cure associated seizures. It is very important to remove the entire malformation because it can grow back if a small piece is left behind. The risk of the operation depends on the size and location of the cavernous malformation and your general health.